Anesth Pain Med.  2017 Jan;12(1):56-61. 10.17085/apm.2017.12.1.56.

Effect of dexmedetomidine on endotracheal intubating conditions during endotracheal intubation without neuromuscular blocker following propofol/remifentanil

• Noh C
• Ko YK
• Kim YH
• Lim CS
• Chung WS
• Lee JY
• Song SH

• KMID: 2369668
• DOI: http://doi.org/10.17085/apm.2017.12.1.56

Abstract

BACKGROUND
In the present study, we investigated the effect of dexmedetomidine on the intubating conditions and hemodynamic changes during endotracheal intubation following anesthetic induction performed using propofol and remifentanil without a neuromuscular blocking agent.
METHODS
We selected 70 adult patients aged 20 to 65 years scheduled to undergo general anesthesia. Induction was performed using 2 mg/kg of propofol and 1.5 µg/kg of remifentanil. The patients were divided into two groups, a dexmedetomidine group (Group D) and a control group (Group C). Group D received an infusion of dexmedetomidine 1 µg/kg for 10 minutes before induction, and Group C received the same volume of normal saline infused in the same manner. Intubating conditions were evaluated and blood pressure and heart rate were recorded at various time points to assess hemodynamic stability.
RESULTS
Intubating conditions were evaluated as excellent for 34 patients and good for 1 patient in Group D, and excellent for 4 patients, good for 20 patients, poor for 4 patients, and bad for 7 patients in Group C (P < 0.001). The heart rate was significantly lower in Group D than in Group C at all measurement times. The mean arterial blood pressure was significantly lower in Group C than in Group D at 10 minutes after dexmedetomidine administration (P = 0.049), after the induction of anesthesia (P < 0.001), immediately after endotracheal intubation (P = 0.008), and 3 minutes after endotracheal intubation (P < 0.001).
CONCLUSIONS
Dexmedetomidine 1 µg/kg improved the intubating conditions and stabilized hemodynamic changes following anesthetic induction performed using propofol 2 mg/kg and remifentanil 1.5 µg/kg without a neuromuscular blocking agent.

Keyword

Dexmedetomidine; Intratracheal; Intubation; Propofol; Remifentanil

MeSH Terms

Adult
Anesthesia
Anesthesia, General
Arterial Pressure
Blood Pressure
Dexmedetomidine*
Heart Rate
Hemodynamics
Humans
Intubation
Intubation, Intratracheal*
Neuromuscular Blockade*
Propofol
Dexmedetomidine
Propofol

Figure

• 

  Fig. 1 The changes in mean heart rate (HR) from initiation of dexmedetomidine or saline infusion to 5 min after endotracheal intubation. Error bar means standard error. ***P < 0.001, **P < 0.01, *P < 0.05 vs. Group C, †††P < 0.001, ††P < 0.01, †P < 0.05 vs. baseline. Group C: The group injected with 0.9% normal saline. Group D: The group injected with dexmedetomidine 1 μg/kg. HR: heart rate.

• 

  Fig. 2 The changes in mean blood pressure (MBP) from initiation of dexmedetomidine or saline infusion to 5 min after endotracheal intubation. Error bar means standard error. ***P < 0.001, **P < 0.01, *P < 0.05 vs Group C, †††P < 0.001, ††P < 0.01, †P < 0.05 vs. baseline. Group C: The group injected with 0.9% normal saline. Group D: The group injected with dexmedetomidine 1 μg/kg. MBP: Mean blood pressure.

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